Characterization of Anti- Dal Alloantibodies Following Sensitization of Two Dal-Negative Dogs.

Since its discovery, the immunogenicity of the Dal blood type has not been further investigated. The aim of this study was to better characterize anti- Dal alloantibodies produced following sensitization of Dal-negative dogs, notably their rate of appearance, the agglutination titer over time, and their immunoglobulin class. A secondary objective was to obtain polyclonal anti- Dal alloantibodies to increase the availability of Dal blood typing. Of 100 healthy laboratory Beagles tested, 2 Dal-negative dogs were identified as recipients. Ten healthy Dal-positive dogs were investigated as potential blood donors. All dogs were extensively blood typed for DEA 1, 3, 4, 5, and 7, as well as for Dal. Then, the recipients were transfused uneventfully with 10 ml/kg of Dal-positive but otherwise compatible packed red blood cells. Posttransfusion blood samples were collected routinely over a minimum of 1 year. Using a gel column technology, anti- Dal alloantibodies were detected as early as 4 days posttransfusion and remained detectable 2 years posttransfusion, with maximum agglutination titers reached at 1 and 2 months posttransfusion. The immunoglobulin class was IgG. The immunogenicity and clinical significance of the Dal blood type were confirmed. The results support the recommendations that previously transfused dogs be crossmatched starting 4 days posttransfusion and for the animal's lifetime. The polyclonal anti- Dal antibodies produced will allow blood typing of a significant number of dogs, especially transfused dogs facing blood incompatibilities and canine blood donors.

Colostrum whey down-regulates the expression of early and late inflammatory response genes induced by Escherichia coli and Salmonella enterica Typhimurium components in intestinal epithelial cells.

Pathogenic invasion by Escherichia coli and Salmonellae remains a constant threat to the integrity of the intestinal epithelium and can rapidly induce inflammatory responses. At birth, colostrum consumption exerts numerous beneficial effects on the properties of intestinal epithelial cells and protects the gastrointestinal tract of newborns from pathogenic invasion. The present study aimed to investigate the effect of colostrum on the early and late inflammatory responses induced by pathogens. The short-term (2 h) and long-term (24 h) effects of exposure to heat-killed (HK) E. coli and Salmonella enterica Typhimurium on gene expression in the porcine intestinal epithelial cell (IPEC-J2) model were first evaluated by microarray and quantitative PCR analyses. Luciferase assays were performed using a NF-κB-luc reporter construct to investigate the effect of colostrum whey treatment on the activation of NF-κB induced by HK bacteria. Luciferase assays were also performed using NF-κB-luc, IL-8-luc and IL-6-luc reporter constructs in human colon adenocarcinoma Caco-2/15 cells exposed to dose-response stimulations with HK bacteria and colostrum whey. Bovine colostrum whey treatment decreased the expression of early and late inflammatory genes induced by HK bacteria in IPEC-J2, as well as the transcriptional activation of NF-κB-luc induced by HK bacteria. Unlike that with colostrum whey, treatment with other milk fractions failed to decrease the activation of NF-κB-luc induced by HK bacteria. Lastly, the reduction of the HK bacteria-induced activation of NF-κB-luc, IL-8-luc and IL-6-luc by colostrum whey was dose dependent. The results of the present study indicate that bovine colostrum may protect and preserve the integrity of the intestinal mucosal barrier in the host by controlling the expression levels of early and late inflammatory genes following invasion by enteric pathogens.

Specific Cues Can Improve Procedural Learning and Retention in Developmental Coordination Disorder and/or Developmental Dyslexia.

The present study investigates procedural learning of motor sequences in children with developmental coordination disorder (DCD) and/or developmental dyslexia (DD), typically-developing children (TD) and healthy adults with a special emphasis on (1) the role of the nature of stimuli and (2) the neuropsychological functions associated to final performance of the sequence. Seventy children and ten adults participated in this study and were separated in five experimental groups: TD, DCD, DD, and DCD + DD children and adults. Procedural learning was assessed with a serial reaction time task (SRTT) that required to tap on a specific key as accurately and quickly as possible when stimuli appeared on the screen. Three types of stimuli were proposed as cues: the classical version of the SRTT with 4 squares aligned horizontally on the screen, giving visuospatial cues (VS cues), and two modified versions, with 4 letters aligned horizontally on the screen (VS + L cues) and letters at the center of the screen (L cues). Reaction times (RT) during the repeated and random blocks allowed assessing three phases of learning: global learning, specific learning and retention of the sequence. Learning was considered as completed when RT evolved significantly in the three phases. Neuropsychological assessment involved, among other functions, memory and attentional functions. Our main result was that learning and retention were not influenced by the available cues in adults whereas learning improved with specific cues in children with or without neurodevelopmental disorders. More precisely, learning was not completed with L cues in children with neurodevelopmental disorders. For children with DD, learning was completed with the VS and VS + L cues whereas for children with DCD (with or without DD), learning was completed with combined VS + L cues. Comorbidity between DD and DCD had no more impact on procedural learning than DCD alone. These results suggest that learning depends on the nature of cues available during practice and that cues allowing learning and retention depend on the type of disorder. Moreover, selective attention was correlated with RT during retention, suggesting that this neuropsychological function is important for procedural learning whatever the available cues.

Lack of evidence of pregnancy-induced alloantibodies in dogs.

BACKGROUND: It is controversial whether or not pregnant bitches become sensitized to red blood cell (RBC) antigens. HYPOTHESIS: Bitches do not develop alloantibodies to RBC antigens during gestation and can be used safely as blood donors. ANIMALS: The study group included 35 healthy female dogs with a prior history of 1 (n = 12), 2 (n = 14), or >or= 3 (n = 9) pregnancies. The control group consisted of 15 healthy female dogs without any history of pregnancy. METHODS: All dogs were blood typed for dog erythrocyte antigens (DEA) 1.1, 1.2, 3, 4, 5, and 7 using ethylenediaminetetraacetic acid blood samples and polyclonal antisera. Antibody screening was performed with serum and canine RBC panels of known blood type. An autocontrol and direct antiglobulin test were performed to rule out the presence of autoantibodies. RESULTS: The only alloantibodies identified were those against DEA 7 and the prevalence of anti-DEA 7 alloantibodies was similar in dogs with known history of pregnancy (11.4%) and in the control group (13.3%). CONCLUSIONS AND CLINICAL IMPORTANCE: These results confirm previous studies and clinical transfusion medicine experience. Naturally occurring anti-DEA 7 alloantibodies have been reported but their clinical relevance has not been shown. Pregnancy does not appear to sensitize dogs to RBC antigens. Consequently, dogs with prior history of pregnancy can be used safely as blood donors. Conversely, no additional pretransfusion compatibility studies would be required should these dogs themselves need to be transfused.

Canadian results from the European Men-who-have-sex-with-men Internet survey (EMIS-2017).

BACKGROUND: In 2017, the international European Men-who-have-sex-with-men Internet Survey (EMIS-2017) collected data from 50 countries, including Canada for the first time. OBJECTIVE: To provide an overview of the Canadian EMIS-2017 data to describe the sexually transmitted and other bloodborne infection (STBBI) related needs of gay, bisexual and other men who have sex with men (gbMSM). METHODS: The EMIS-2017 questionnaire was an updated version of EMIS-2010. It included self-reported sociodemographic data, experience of discrimination, mental health and substance use, knowledge of preexposure prophylaxis (PrEP) for HIV, sexual practices and history of STBBI testing and diagnosis. Analysis was largely descriptive. RESULTS: Of the 6,059 respondents from Canada, 5,165 participants met the inclusion criteria for this analysis. The majority of participants were born in Canada (79.3%); and over half of the respondents (56.7%) were under the age of 39. In terms of discrimination related to their attraction to other men, participants reported high levels of intimidation (31.9%), verbal abuse (22.1%) and physical violence (1.5%) in the previous year. Regarding mental health, 23.9% had a moderate to severe depression/anxiety score. Almost two-thirds (64.1%) indicated substance use and one-fifth (21.5%) reported chemsex (or the use of stimulant drugs to make sex more intense or last longer). Only 8.4% of participants reported use of PrEP for HIV; however, 51.7% reported being likely to use PrEP if it was available and affordable. Sexual practices, such as condom use, varied by PrEP use with 91.3% of men using PrEP reporting condomless anal intercourse (CAI) compared with 71.5% of men not on PrEP. In terms of STBBI testing, 1.5% reported being diagnosed with hepatitis C and 9.0% reported an HIV diagnosis. Of those with an HIV diagnosis, most were on treatment (99.1%) and had an undetectable viral load (96.7%). CONCLUSION: gbMSM in Canada experienced stigma, discrimination and mental health problems; substance use was high as were high-risk sexual practices, such as CAI, among some groups of men. There was a gap between the proportion of men who were interested in PrEP and those who actually used it; and comprehensive STBBI testing was low.These findings can inform public health action and provide a baseline to examine the impact of current and new interventions.

Anticoagulant activity of oral rivaroxaban in healthy dogs.

Rivaroxaban is an oral, direct factor Xa inhibitor used in human thrombotic disorders. In view of the in vitro concentration dependent anticoagulant effects of rivaroxaban in dogs, the time course of its anticoagulant effects was characterized in healthy dogs. Twenty-four healthy Beagles were randomized into three groups (n = 8 per group) and received orally either a placebo or 20 mg rivaroxaban once or twice at an 8 h interval. Fifteen blood samples were collected over a 30 h period, and blindly assayed for prothrombin time (PT), activated partial thromboplastin time (aPTT), tissue factor induced thrombin generation (TG) and anti-factor Xa activity. Thromboelastography (TEG) was evaluated at 0, 1, 4, 8 and 24 h. Peak/baseline anticoagulant effect ratios were analyzed with generalized linear models using ß distributions and times to return to baseline with survival analyses (α = 0.05). Peak/baseline anticoagulant effect ratios of PT, aPTT, anti-factor Xa activity, TG and R (TEG) differed significantly between placebo and both rivaroxaban groups (P <0.0001). The peak anticoagulant effect of rivaroxaban occurred 1.5 to 2 h after dosing. The median return to baseline occurred significantly sooner (P <0.01) with 20 mg rivaroxaban administered once (7.9-18.7 h) versus twice (17.5-26.8 h). The inter-individual variability differed amongst assays, but overall was moderate to large. No adverse effects were recorded. Twice oral administration of 2 mg/kg rivaroxaban at an 8 h interval maintained 24 h anticoagulant activity, but larger studies are needed to establish guidelines for the use of rivaroxaban in dogs.

Prevalence and Mode of Inheritance of the Dal Blood Group in Dogs in North America.

BACKGROUND: The Dal blood group system was identified a decade ago by the accidental sensitization of a Dal- Dalmatian with a Dal+ blood transfusion. Similar Dal-related blood incompatibilities have been suspected in other Dalmatians, Doberman Pinschers, and other breeds. OBJECTIVES: To determine the prevalence and mode of inheritance of the Dal antigen expression in dogs. ANIMALS: A total of 1130 dogs including 128 Dalmatians, 432 Doberman Pinschers, 21 Shih Tzus, and 549 dogs of other breeds including 228 blood donors were recruited from North America between 2008 and 2015. METHODS: Prospectively, dogs were blood typed for Dal applying a gel column technique using polyclonal canine anti-Dal sera. Pedigrees from 8 typed families were analyzed. RESULTS: The prevalence of the Dal+ blood type varied between 85.6 and 100% in Dalmatians and 43.3-78.6% in Doberman Pinschers depending on geographical area. Dal- dogs were identified mostly in Dalmatians (15/128; 11.7%), Doberman Pinschers (183/432; 42.4%), and Shih Tzus (12/21; 57.1%), and sporadically in mixed-breed dogs (3/122; 2.5%), Lhasa Apsos (1/6) and Bichon Frises (1/3). Only 6/245 (2.4%) blood donors were found to be Dal-, including 5 Doberman Pinschers. The mode of inheritance of the Dal+ phenotype was determined to be autosomal dominant. CONCLUSIONS AND CLINICAL IMPORTANCE: The high percentage of Dal- Doberman Pinchers, Dalmatians and Shih Tzus increases their risk of being sensitized by a blood transfusion from the common Dal+ donor. Extended Dal typing is recommended in those breeds and in dogs when blood incompatibility problems arise after initial transfusions.

Update on Canine and Feline Blood Donor Screening for Blood-Borne Pathogens.

An update on the 2005 American College of Veterinary Internal Medicine (ACVIM) Consensus Statement on blood donor infectious disease screening was presented at the 2015 ACVIM Forum in Indianapolis, Indiana, followed by panel and audience discussion. The updated consensus statement is presented below. The consensus statement aims to provide guidance on appropriate blood-borne pathogen testing for canine and feline blood donors in North America.

Therapeutic angiogenesis with recombinant fibroblast growth factor-2 improves stress and rest myocardial perfusion abnormalities in patients with severe symptomatic chronic coronary artery disease.

BACKGROUND: We report the effects of the administration of recombinant fibroblast growth factor-2 (rFGF-2) protein on myocardial perfusion using single photon emission computed tomography imaging in humans with advanced coronary disease. METHODS AND RESULTS: A total of 59 patients with coronary disease that was not amenable to mechanical revascularization underwent intracoronary (n=45) or intravenous (n=14) administration of rFGF-2 in ascending doses. Changes in perfusion were evaluated at baseline and again at 29, 57, and 180 days after rFGF-2 administration. In this uncontrolled study, perfusion scans were analyzed by 2 observers who were blinded to patient identity and test sequence; scans were displayed in random order, with scans from nonstudy patients randomly interspersed to enhance blinding. Combining all dose groups, a reduction occurred in the per-segment reversibility score (reflecting the magnitude of inducible ischemia) from 1.7+/-0.4 at baseline to 1.1+/-0.6 at day 29 (P:<0.001), 1.2+/-0.7 at day 57 (P:<0.001), and 1.1+/-0.7 at day 180 (P:<0.001). The 37 patients with evidence of resting hypoperfusion had evidence of improved resting perfusion: their per-segment rest perfusion score of 1.5+/-0. 5 at baseline decreased to 1.0+/-0.8 at day 29 (P:<0.001), 1.0+/-0.8 at day 57 (P:=0.003), and 1.1+/-0.9 at day 180 (P:=0.11). CONCLUSIONS: These preliminary data suggest that the administration of rFGF-2 to patients with advanced coronary disease resulted in an attenuation of stress-induced ischemia and an improvement in resting myocardial perfusion; these findings are consistent with a favorable effect of therapeutic angiogenesis.

Pregnancy complications and neonatal outcomes in women with eating disorders.

OBJECTIVE: This study reported pregnancy complications and neonatal outcomes for 49 live births in a group of women with eating disorders who were prospectively followed. METHOD: Subjects were recruited from 246 women participating in a longitudinal study of anorexia nervosa and bulimia nervosa, now in its 12th year. Subjects were interviewed by trained assistants and completed a brief self-report instrument that assessed both birth statistics and birth-related complications. Medical records and/or self-report data describing the neonates' birth status were obtained. RESULTS: The majority of the women with eating disorders had normal pregnancies, resulting in healthy babies. Across the group, the mean length of pregnancy was 38.7 weeks, the mean birth weight was 7.6 lb, and mean Apgar scores at 1 and 5 minutes after birth were 8.2 and 9.0, respectively. Most outcomes were positive; however, three babies (6.1%) had birth defects, and 17 (34.7%) of the women experienced postpartum depression. The mean number of obstetric complications in the group was 1.3, and 13 (26.5%) of the women delivered by cesarean section. Women who showed symptoms of either anorexia nervosa or bulimia nervosa during pregnancy had a higher frequency of birth by cesarean section and postpartum depression than did nonsymptomatic women. CONCLUSIONS: Pregnant women with active eating disorders appear to be at greater risk for delivery by cesarean section and for postpartum depression. Pregnant women with past or current eating disorders should be viewed as being at high risk and monitored closely both during and after pregnancy to optimize maternal and fetal outcomes.

Five-factor personality traits in patients with seasonal depression: treatment effects and comparisons with bipolar patients.

BACKGROUND: Increasingly, the Five Factor Model (FFM) of personality is being used to assess personality characteristics of patients with Axis I disorders. Recent study indicates that patients with the seasonal subtype of major depression (SAD) may differ meaningfully from other depressed patients. In the present study, we further examined this finding, with attention to the stability of personality characteristics across treatment. METHODS: We used the NEO-FFM to assess the personality characteristics of two samples of depressed outpatients: patients with SAD and patients with bipolar disorder. Assessment was repeated in the SAD patients after light therapy. RESULTS: Consistent with previous research, we found elevated scores on the Openness domain in the SAD patients. SAD patients also scored significantly lower on Neuroticism and significantly higher on the Conscientiousness and Extroversion domains than patients with bipolar disorder. Scores on the Openness domain remained elevated after treatment of SAD; this occurred in the context of significant decreases in Neuroticism and increases in Extroversion scores. LIMITATIONS: These results were obtained in a relatively small-sample study. Although our sample of bipolar patients were taking mood stabilizers, it is unlikely that medication effects could explain our results. CONCLUSIONS: Our findings are consistent with those reported by Bagby et al. (Major depression and the five-factor model of personality. J. Pers. Disord. 1995;9:224-234) and suggests that Neuroticism and Extroversion are the FFM domains most responsive to treatment for depression. Our results also suggest that elevations on the Openness domain do not change with treatment and may be an enduring characteristic of patients with SAD.

Trace metal requirements in total parenteral nutrition (TPN). 5. Formation constants for the copper(II)--histidine ternary complexes with threonine, lysine, glycine, phenylalanine, valine, and cystine, and discussion of their implications regarding the copper distribution in blood plasma during TPN and the evaluation of the daily dose of copper.

Specific metal deficiencies have been reported to affect patients receiving total parenteral nutrition (TPN). Our previous studies on the topic were devoted to the computer-based interpretation of the extra urinary excretion of zinc; a theoretical approach was also proposed, with a view to compensating for the extra losses of this metal. Similarly, the present work deals with the problem of TPN-induced copper deficiency and its remedy. As is the case for zinc, the TPN-induced excretion of copper clearly stems from the relative mobilization of the plasma protein-bound pool of this metal into its diffusable low-molecular-weight fraction; this phenomenon being due to the competitive complexation of copper by the amino acids of the nutritive solution. The computer simulation of this effect thus required that first the equilibrium constants be experimentally determined for the main complexes of copper that might form in the solution as well as in plasma during the infusion. Accordingly, complex formation in the copper-histidine ternary systems with threonine, lysine, glycine, phenylalanine, valine, and cystine was investigated by potentiometry at 37 degrees C in NaCIO4 0.15 mol X dm-3. The implications of the results obtained are discussed with regard to the interpretation of the copper excretion and the estimation of the desirable daily dose of this metal for the TPN mixture under consideration.

Management of malignant melanoma of the head and neck using dynamic lymphoscintigraphy and gamma probe-guided sentinel lymph node biopsy.

BACKGROUND: The sentinel lymph node (SLN) biopsy is revolutionizing the surgical management of primary malignant melanoma. It allows accurate nodal staging, and targets patients who may benefit from regional lymphadenectomy and systemic therapy; however, its use in the management of head and neck melanoma has not been widely accepted. METHODS: A retrospective review of patients treated for clinical stages I and II malignant melanoma of the head and neck with dynamic lymphoscintigraphy and gamma probe-guided SLN biopsy. RESULTS: Fifty-eight patients (47 male and 11 female) were identified. Primary melanoma sites included the scalp (21), ear (8), face (13), neck (15), and eyelid (1). Primary tumor staging was T2 (11), T3 (24), and T4 (23). Dynamic lymphoscintigraphy visualized SLNs in 57 patients (98.3%). In 43 cases (75%) a single draining nodal basin was identified, and in 14 cases there were multiple draining nodal basins. Sentinel lymph nodes were successfully identified in 72 (96%) of 75 nodal basins. Positive SLNs were identified in 10 patients (17.5%). Sentinal lymph node positivity by tumor staging was T3, 16.7% and T4, 27.3%. Completion lymphadenectomy revealed residual disease in 3 patients (30%). Relapse occurred in 10 (21.3%) of the 47 patients with negative SLN biopsy results and 7 (70%) of those with positive results. CONCLUSIONS: Gamma probe-guided SLN localization in the head and neck region was successful in 96% of draining nodal basins. It can target regional lymphadenectomy in patients who may benefit from regional nodal dissection.

Effect of angiotensin-converting enzyme inhibitor therapy in mitral regurgitation with normal left ventricular function.

Mitral regurgitation (MR) is a common, frequently asymptomatic valvulopathy that can ultimately lead to left ventricular failure. With the objective of forestalling MR progression, a prospective, placebo controlled, double-blind study was conducted. It measured the effectiveness of lisinopril, an angiotensin-converting enzyme inhibitor, in reducing the echocardiographic signs of MR severity over a one-year period. Severe coronary disease was excluded by stress echocardiography. Treatment effectiveness was estimated to be proportional to the reduction in MR fraction and cardiac chamber dimensions, compared with baseline, according to intention-to-treat analysis. A final patient population of 23 asymptomatic adults aged 53.3 +/- 2.4 years (mean +/- SEM), with moderate, organic MR and normal left ventricular function was selected from the echocardiographic database. All baseline patient characteristics were comparable in the two treatment groups, including the MR fraction (55 +/- 3%). Twelve patients received lisinopril (18 +/- 1 mg) and 11 received placebo. After one year of treatment, a statistically significant difference in the MR fraction was observed between the two groups. For the lisinopril group the MR fraction dropped by 6.4 +/- 3.5% and for the placebo group it increased by 3.7 +/- 3.2% versus baseline (P < 0.05). No differences in left atrial or ventricular dimensions were observed. The study drug was stopped in four patients after one patient presented with rapid atrial fibrillation and angina while three patients were intolerant to lisinopril. Only one patient receiving placebo was taken off therapy. In conclusion, treatment with lisinopril indicates some reduction in the severity of chronic moderate MR in asymptomatic patients with normal left ventricular function. This approach appears to be safe, but side effects are not uncommon, warranting regular follow-up.

Surgical management of malignant melanoma using dynamic lymphoscintigraphy and gamma probe-guided sentinel lymph node biopsy: the Emory experience.

Sentinel lymph node (SLN) biopsy is revolutionizing the surgical management of primary malignant melanoma. It allows accurate nodal staging which targets patients who may benefit from regional lymphadenectomy and systemic therapy. This is a retrospective review of patients treated at Emory University for stage I and II malignant melanoma with gamma probe-guided SLN biopsy from 1/1/94 to 6/30/98. Three hundred sixty patients (males 228, females 132) were identified. Primary melanoma sites included: head and neck 58, trunk 148, and extremities 154 (upper 71, lower 83). Primary tumor staging was T1 9, T2 134, T3 153, and T4 64. SLNs were successfully identified in 99.7 per cent of patients and 98.9 per cent of nodal basins mapped. In 275 (76.6%) cases a single draining nodal basin was identified. In 84 (23.3%) cases there were multiple draining nodal basins. Positive SLNs were identified in 63 patients (17.5%). SLN positivity by tumor staging was T1 0 per cent, T2 9.0 per cent, T3 22.2 per cent, and T4 26.6 per cent. The overall recurrence rate was 11.9 per cent. Recurrences by SLN status were SLN+, 27 per cent, and SLN-, 8.8 per cent. Regional recurrence occurred in 7 (2.4%) of the 297 with negative SLN biopsies and 7 (11.1%) of the 63 with positive SLN biopsies. Dynamic lymphoscintigraphy and gamma probe-guided SLN localization was successful in more than 98 per cent of cases. Patients with negative SLN biopsies have a low risk of recurrence.

A psychometric evaluation of the DSM-IV personality disorder criteria.

In this study, we examined the psychometric quality of the recently revised DSM-IV Personality Disorders (PD). A nationally drawn sample of mental health professionals rated 280 patients known to them, using a symptom checklist containing all the DSM-IV PD criteria. From this symptom level data we determined internal consistency, convergent validity, and discriminant validity for each DSM-IV PD criteria. Overall, the findings were encouraging. The internal consistency--a measure of reliability--of the PD criteria sets appears to be substantially improved. The median coefficient alpha for the DSM-IV PDs was .73. Convergent validity was generally adequate for the DSM-IV PD criteria sets. However, discriminant validity, a measure of the specificity of a criterion's relationship to its parent scale, continues to be a problem of the PDs. The findings suggest that the DSM-IV PDs may have better reliability than did their DSM-III-R predecessors. However, the weak discriminant validity found for the DSM-IV PD criteria sets indicates that the Axis II system will continue to show high levels of comorbidity. The usefulness of psychometric procedures in the development and refinement of the DSM PDs is also highlighted.

Psychometric characteristics of the cluster B personality disorders under DSM-III-R and DSM-IV.

A stated goal for the latest revision of the DSM was improving the performance of the Axis II system. To evaluate the degree to which this goal was achieved, we performed a psychometric analysis of the Cluster B personality disorders (PD) as they are defined under the DSM-III-R and its successor the DSM-IV. Ninety-four patients with a primary PD diagnosis were rated for the presence of DSM-III-R and DSM-IV Cluster B PD criteria. From this symptom level data, the convergence, divergence, and internal consistency of the Cluster B criteria sets were determined. Also, kappa values were computed between the DSM-III-R and DSM-IV versions of these disorders as an index of coverage or agreement across the two systems. The results indicated that, in general, the DSM-IV Cluster B PDs represent an improvement over their DSM-III-R predecessors. However, some psychometric limitations, particularly regarding the convergence of the criteria sets, continue to be present.

Toward an empirical/theoretical grouping of the DSM-III-R personality disorders.

Despite some recent favorable findings, there has not been strong empirical support for the validity of DSM-III-R--and now DSM-IV--personality disorder (PD) clusters. In this study, Axis II symptom ratings on 320 personality disordered patients were used to obtain dimensional scores for the 11 DSM-III-R PDs. The dimensional scores for the DSM PDs were subjected to a principal component analysis with orthoginal rotation. Three factors emerged having eigenvalues > or = than 1. The pattern of factor loadings for the individual PDs were not consistent with the DSM Cluster. Rather, the factor loadings were quite consistent with Millon's theory of personality. These results are discussed in light of the clinical benefits provided by employing empirically determined and theoretically anchored model for organizing the Axis II disorders.

Stress/injection protocols for myocardial scintigraphy with 99Tcm-sestamibi compared with 201Tl: implications of early post-stress kinetics.

Stress/injection protocols developed for myocardial perfusion imaging with 201Tl may not be optimal for 99Tcm-sestamibi (MIBI), an agent with lower myocardial extraction and higher abdominal uptake; prolongation of exercise after radiotracer injection might improve these relative drawbacks of MIBI. We compared the kinetics of MIBI and 201Tl by acquiring dynamic planar images for 5-7 min after a bolus injection (n = 180 studies) with stress performed by supine bicycle exercise alone, intravenous dipyridamole or combined stress. Routine or prolonged protocols involved continuation of exercise for 1 or 2.5 min respectively after tracer appearance in the heart. Subsequently, the perfusion images obtained were categorized as normal or showing significant defects. Myocardial uptake of MIBI, normalized for injected dose, body weight and camera sensitivity, was only 40% of that for 201Tl; there were no differences based on test mode or scan result for either perfusion tracer. During the second minute after injection, the cavity/myocardial ratios, an index of blood pool activity, were elevated with MIBI by 25% when compared with 201Tl (P < 0.001). During the third minute, cavity activity was again higher with MIBI, but only in those subjects with abnormal scans. The prolonged exercise phase did not prevent progressive accumulation in the abdomen, but did allow cavity levels to decline before termination of exercise. The prolonged protocol may ensure that myocardial uptake of MIBI is completed during peak blood flow, and therefore is recommended for stress with exercise or with dipyridamole and exercise in combination.

A rapid method for macerating phloem.

Sieve cells and sieve tube members can be macerated from the phloem of various organs of woody and herbaceous species by autoclaving the tissue in a mild macerating medium. This treatment does not digest the primary walls or the callose deposits on the sieve areas and sieve plates of the sieve elements. These cells can then be recognized by the fluorescence of their callose after staining with aniline blue. Sometimes adjacent sieve elements fail to separate and one can observe details of their junctures.